Todd T R, Weisbrod G, Tao L C, Sanders D E, Delarue N C, Chamberlain D W, Ilves R, Pearson F G, Cass W, Cooper J D
Ann Thorac Surg. 1981 Aug;32(2):154-61. doi: 10.1016/s0003-4975(10)61023-5.
We reviewed our experience with 2,114 percutaneous aspiration needle biopsies of intrathoracic lesions. Aspiration was performed for cytological diagnosis employing biplane fluoroscopy and a 20 gauge needle, 0.9 mm in outside diameter. A satisfactory specimen was obtained in 88% of biopsies, and the chance of obtaining a correct diagnosis of a malignant lesion was 81.5%. The false positive rate was 2.3%, and the cytologists could always distinguish between primary and secondary neoplasms. A false negative rare of 13.6% (36 patients) resulted in only three delayed thoracotomies and two instances of interval metastases discovered at mediastinoscopy. Cellular specificity in primary tumors was not sufficiently accurate to affect therapy. Pneumothoraces occurred frequently (31.9% of patients) but wee generally small; 10.4% of patients required chest drainage. There were no recorded instances of tumor implantation in needle tracts. We conclude that a rapid and accurate diagnosis of intrathoracic pathology can be obtained by this technique. It is associated with an acceptable morbidity and may greatly expedite both patient care and investigation.
我们回顾了2114例经皮穿刺针吸活检术对胸内病变的诊治经验。采用双平面荧光镜检查法及外径0.9mm的20号针进行针吸活检，以获取细胞进行诊断。88%的活检获取了满意标本，正确诊断恶性病变的概率为81.5%。假阳性率为2.3%，细胞学家总能区分原发性肿瘤和继发性肿瘤。13.6%（36例患者）的假阴性率仅导致3例延迟开胸手术及2例在纵隔镜检查时发现的间隔期转移。原发性肿瘤的细胞特异性不够准确，无法影响治疗。气胸发生率较高（31.9%的患者），但通常程度较轻；10.4%的患者需要胸腔引流。未记录到针道种植肿瘤的病例。我们得出结论，该技术可快速准确地诊断胸内病变，其相关发病率可接受，且可极大地加快患者治疗和检查进程。
